Individual provider Active NPI

Sabeeha Naazneen Shaik, MD

  • Pediatrics Physician
  • Fremont, OH
National Provider Identifier
1336757350
Registry record updated Sep 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
35.147875 Issued in OH
Practice address
715 S Taft Ave
Fremont, OH 43420-3237
Phone
(419) 334-6679
Fax
(419) 334-6690
NPI assigned
Jul 15, 2020
Last updated
Sep 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 35.147875 OH Primary

Addresses

Primary practice location

715 S Taft Ave
Fremont, OH 43420-3237

Mailing address

2575 Hayes Ave Ste 1
Fremont, OH 43420-5201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240117000555 OH Practitioner - Pediatric Medicine 5597175893 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
35.147875OHMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Memorial Professional Services LTD CurrentSince Dec 3, 2023 Accepting new patients
Memorial Hospital Past Accepting new patients

Locations

2575 Hayes Ave
Ste 1
Fremont, OH 43420
Phone (419) 332-1551

715 S Taft Ave
Ste 3B13B2
Fremont, OH 43420

715 S Taft Ave
Fremont, OH 43420
Phone (419) 332-7321

Interoperability endpoints

  • Direct secure messaging: sshaik272365@direct.promedica.org

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1594771200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695772800000",
    "number": "1336757350",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2575 HAYES AVE STE 1",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434205201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "715 S TAFT AVE",
            "city": "FREMONT",
            "state": "OH",
            "postal_code": "434203237",
            "telephone_number": "419-334-6679",
            "fax_number": "419-334-6690"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAIK",
        "first_name": "SABEEHA NAAZNEEN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-15",
        "last_updated": "2023-09-27",
        "certification_date": "2023-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "OH",
            "license": "35.147875",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fremont, OH

Sources for this page

Verify at the official NPI Registry.